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House Journal: Wednesday, April 2, 2003

JOURNAL OF THE HOUSE

Eightieth Calendar Day - Fifty-seventh Session Day

Hall of the House of Representatives
Des Moines, Iowa, Wednesday, April 2, 2003

The House met pursuant to adjournment at 8:57 a.m., Speaker
Rants in the chair.

Prayer was offered by Reverend Duane Marburger, chaplain of
Ottumwa Good Samaritan Rehabilitation and Health Center,
Bloomfield. He was the guest of Representative Kurt Swaim of Davis
County.

The Journal of Monday, April 1, 2003 was approved.

PLEDGE OF ALLEGIANCE

The Pledge of Allegiance was led by Speaker Rants.

SENATE MESSAGE CONSIDERED

Senate File 383, by committee on education, a bill for an act
authorizing the establishment of an Iowa virtual academy,
authorizing the board of educational examiners to license instructors
of internet courses, and providing an effective date.

Read first time and referred to committee on education.

SPECIAL PRESENTATION
Pella Tulip Festival

Van Engelenhoven of Marion presented to the House, Ashley
Braun, Queen of the 2003 Pella Tulip Festival and escorted her and
her court to the Speaker’s station.

Queen Braun presented her attendants, Elizabeth Terborg, Tiffany
Pol, Amy Laug and Katie Kniff.

Also present from Pella were the parents of the Queen and her
court, who wore native Dutch costumes and distributed the famous
Pella Dutch cookies.

Queen Braun addressed the House briefly and invited everyone to
attend the Pella Tulip Festival on May 1, 2 and 3, 2003.

The House rose and expressed its welcome and appreciation.

On motion by Gipp of Winneshiek, the House was recessed at 9:04
a.m., until 1:00 p.m.

AFTERNOON SESSION

The House reconvened at 12:58 p.m., Speaker Rants in the chair.

QUORUM CALL

A non-record roll call was requested to determine that a quorum
was present. The vote revealed seventy-one members present,
twenty-nine absent.

The House stood at ease at 1:06 p.m., until the fall of the gavel.

The House resumed session at 3:13 p.m., Speaker Rants in the
chair.

CONSIDERATION OF BILLS
Regular Calendar

Senate Joint Resolution 1, a joint resolution authorizing the
temporary use and consumption of wine in the State Capitol in
conjunction with the awards ceremony of the World Food Prize
Foundation with report of committee recommending passage, was
taken up for consideration.

Jacobs of Polk moved that the joint resolution be read a last time
now and placed upon its adoption and the joint resolution was read a
last time.

On the question "Shall the joint resolution be adopted and agreed
to?" (S.J.R. 1)

The yeas were, 86:

Baudler Bell Berry Boddicker
Boggess Bukta Carroll Cohoon
Connors Dandekar Davitt Dennis
Dix Dolecheck Drake Elgin
Fallon Foege Ford Freeman

Frevert Gaskill Gipp Granzow
Greimann Greiner Hahn Hansen
Hanson Heaton Heddens Hogg
Horbach Hunter Huseman Huser
Hutter Jacobs Jochum Jones
Kramer Kuhn Kurtenbach Lensing
Lukan Lykam Maddox Manternach
Mascher McCarthy Mertz Miller
Murphy Myers Oldson Olson, D.
Olson, S. Osterhaus Paulsen Petersen
Quirk Raecker Rayhons Reasoner
Sands Schickel Shoultz Smith
Stevens Struyk Swaim Taylor, T.
Thomas Tjepkes Tymeson Upmeyer
Van Fossen, J.K. Van Fossen, J.R. Watts Wendt
Whitaker Whitead Wilderdyke Winckler
Wise Mr. Speaker
Rants

The nays were, 12:
Alons Arnold Boal Chambers De Boef Eichhorn Klemme Lalk Rasmussen Roberts Taylor, D. Van Engelenhoven

 


Absent or not voting, 2:
Hoffman Jenkins

 


The joint resolution having received a constitutional majority was
declared to have been adopted and agreed to by the House.

MESSAGES FROM THE SENATE

The following messages were received from the Senate:

Mr. Speaker: I am directed to inform your honorable body that the Senate has on
April 2, 2003, passed the following bill in which the concurrence of the Senate was
asked:

House File 289, a bill for an act relating to electronic financial transactions with
county treasurers.

Also: That the Senate has on April 2, 2003, passed the following bill in which the
concurrence of the Senate was asked:

House File 341, a bill for an act relating to personnel and instructors employed by
community colleges.


Also: That the Senate has on April 2, 2003, passed the following bill in which the
concurrence of the Senate was asked:

House File 342, a bill for an act relating to the use of sick leave by certain members
of the Iowa department of public safety peace officers' retirement, accident, and
disability system who are temporarily incapacitated for duty.

Also: That the Senate has on April 2, 2003, passed the following bill in which the
concurrence of the Senate was asked:

House File 479, a bill for an act designating advanced registered nurse practitioners
as providers of health care services pursuant to managed care or prepaid services
contracts under the medical assistance program.

Also: That the Senate has on April 2, 2003, passed the following bill in which the
concurrence of the House is asked:

Senate File 344, a bill for an act concerning regulatory and statutory requirements
impacting business relating to liability reform, unemployment compensation benefits
eligibility and employer contributions, workers' compensation, occupational safety and
health administration training and compliance requirements, financial services and
restrictions on property rights, environmental regulatory requirements, and public
project contractor requirements.

MICHAEL E. MARSHALL, Secretary

HOUSE FILE 664 WITHDRAWN

De Boef of Keokuk asked and received unanimous consent to
withdraw House File 664 from further consideration by the House.

IMMEDIATE MESSAGE

Gipp of Winneshiek asked and received unanimous consent that
Senate Joint Resolution 1 be immediately messaged to the Senate.

Gipp of Winneshiek asked and received unanimous consent for the
immediate consideration of House File 659.

House File 659, a bill for an act relating to ownership of alternate
energy production facilities by public utilities, making related
changes, and providing an effective date, with report of committee
recommending amendment and passage, was taken up for
consideration.


Jenkins of Black Hawk offered the following amendment H-1218
filed by the committee on commerce, regulation and labor and moved
its adoption:

H-1218

1 Amend House File 659 as follows:
2 1. By striking page 3, line 32, through page 4,
3 line 8, and inserting the following:
4 "b. In determining the applicable ratemaking
5 principles, the board shall not be limited to
6 traditional ratemaking principles or traditional cost
7 recovery mechanisms. Among the principles and
8 mechanisms the board may consider, the board has the
9 authority to approve ratemaking principles proposed by
10 a rate-regulated public utility that provide for
11 reasonable restrictions upon the ability of the public
12 utility to seek a general increase in electric rates
13 under section 476.6 for at least three years after the
14 generation facility begins providing service to Iowa
15 customers."
16 2. By renumbering, redesignating, and correcting
17 internal references as necessary.

The committee amendment H-1218 was adopted.

Jenkins of Black Hawk moved that the bill be read a last time now
and placed upon its passage which motion prevailed and the bill was
read a last time.

On the question "Shall the bill pass?" (H.F. 659)

The ayes were, 98:
Alons Baudler Bell Berry
Boal Boddicker Boggess Bukta
Carroll Chambers Cohoon Connors
Dandekar Davitt De Boef Dennis
Dix Dolecheck Drake Eichhorn
Elgin Fallon Foege Ford
Freeman Frevert Gaskill Gipp
Granzow Greimann Greiner Hahn
Hansen Hanson Heaton Heddens
Hoffman Hogg Horbach Hunter
Huseman Huser Hutter Jacobs
Jenkins Jochum Jones Klemme
Kramer Kuhn Kurtenbach Lalk
Lensing Lukan Lykam Maddox
Manternach Mascher McCarthy Mertz
Miller Murphy Myers Oldson
Olson, D. Olson, S. Osterhaus Paulsen
Petersen Quirk Raecker Rasmussen
Reasoner Roberts Sands Schickel
Shoultz Smith Stevens Struyk
Swaim Taylor, D. Taylor, T. Thomas
Tjepkes Tymeson Upmeyer Van Engelenhoven
Van Fossen, J.K. Van Fossen, J.R. Watts Wendt
Whitaker Whitead Wilderdyke Winckler
Wise Mr. Speaker
Rants

 


The nays were, 1:
Arnold

 


Absent or not voting, 1:
Rayhons

 


The bill having received a constitutional majority was declared to
have passed the House and the title was agreed to.

IMMEDIATE MESSAGE

Gipp of Winneshiek asked and received unanimous consent that
House File 659 be immediately messaged to the Senate.

Appropriations Calendar

House File 662, a bill for an act relating to the funding of, the
operation of, and appropriation of moneys to the college student aid
commission, the department for the blind, the department of cultural
affairs, the department of education, and the state board of regents
and including an effective date and retroactive applicability date
provision, was taken up for consideration.

Winckler of Scott asked and received unanimous consent that
amendment H-1210 be deferred.

Dolecheck of Ringgold offered amendment H-1195 filed by him and
Upmeyer of Hancock as follows:

H-1195

1 Amend House File 662 as follows:
2 1. Page 11, by striking lines 4 through 21 and

3 inserting the following:
4 " $139,260,763
5 The funds appropriated in this subsection shall be
6 allocated as follows:
7 a. Merged Area I $ 6,683,208
8 b. Merged Area II $ 7,850,326
9 c. Merged Area III $ 7,292,776
10 d. Merged Area IV $ 3,564,554
11 e. Merged Area V $ 7,457,487
12 f. Merged Area VI $ 6,909,220
13 g. Merged Area VII $ 9,969,086
14 h. Merged Area IX $ 12,261,253
15 i. Merged Area X $ 19,242,498
16 j. Merged Area XI $ 20,423,208
17 k. Merged Area XII $ 8,046,150
18 l. Merged Area XIII $ 8,273,870
19 m. Merged Area XIV $ 3,607,057
20 n. Merged Area XV $ 11,350,140
21 o. Merged Area XVI $ 6,329,930"
22 2. Page 11, by inserting before line 22 the
23 following:
24 "Sec. 101. SUPPLEMENTAL AID FOR COMMUNITY
25 COLLEGES. Notwithstanding the provisions of section
26 8.33 or any other provision of law to the contrary,
27 moneys from the appropriation made in 2001 Iowa Acts,
28 chapter 177, section 1, reserved for purposes of
29 section 284.13, subsection 1, paragraph "a", which
30 remain unexpended or unencumbered on June 30, 2003,
31 shall be spent by the department of education in the
32 following amount to supplement the general state
33 financial aid provided to community colleges pursuant
34 to section 5, subsection 14 of this Act:
35 $ 762,675
36 The funds allocated in this subsection shall be
37 distributed as follows:
38 a. Merged Area I $ 36,600
39 b. Merged Area II $ 42,993
40 c. Merged Area III $ 39,940
41 d. Merged Area IV $ 19,522
42 e. Merged Area V $ 40,842
43 f. Merged Area VI $ 37,839
44 g. Merged Area VII $ 54,597
45 h. Merged Area IX $ 67,150
46 i. Merged Area X $ 105,383
47 j. Merged Area XI $ 111,850
48 k. Merged Area XII $ 44,066
49 l. Merged Area XIII $ 45,313
50 m. Merged Area XIV $ 19,754

Page 2

1 n. Merged Area XV $ 62,160

2 o. Merged Area XVI $ 34,666"
3 3. Page 22, by inserting after line 23 the
4 following:
5 "Sec. . Section 261.25, subsection 1, Code
6 2003, is amended to read as follows:
7 1. There is appropriated from the general fund of
8 the state to the commission for each fiscal year the
9 sum of forty-six million one four hundred seventeen
10 thousand nine hundred sixty-four dollars for tuition
11 grants."
12 4. Page 25, by inserting after line 23 the
13 following:
14 "___. Section 101 of this Act, relating to the
15 supplemental aid for community colleges, being deemed
16 of immediate importance, takes effect upon enactment."
17 5. Page 25, lines 31 and 32, by striking the
18 words and figures "and applies retroactively to June
19 30, 2002".
20 6. By renumbering as necessary.

Frevert of Palo Alto asked and received unanimous consent to
withdraw amendment H-1230, to amendment H-1195, filed by her
from the floor.

On motion by Dolecheck of Ringgold amendment H-1195 was
adopted, placing out of order amendment H-1207 filed by Frevert of
Palo Alto, et al., on April 1, 2003 and amendment H-1209 filed by
Davitt of Warren, et al., on April 1, 2003.

Greimann of Story asked and received unanimous consent that
amendment H-1208 be deferred.

Jenkins of Black Hawk asked and received unanimous consent to
withdraw amendment H-1204 filed by him on March 31, 2003.

Jenkins of Black Hawk asked and received unanimous consent
that amendment H-1221 be deferred.

The House stood at ease at 4:35 p.m., until the fall of the gavel.

The House resumed session at 5:08 p.m., Speaker Rants in the
chair.

Gipp of Winneshiek asked and received unanimous consent that
House File 662 be deferred and that the bill be placed on the

unfinished business calendar.

MESSAGES FROM THE SENATE

The following messages were received from the Senate:

Mr. Speaker: I am directed to inform your honorable body that the Senate has on
April 2, 2003, passed the following bill in which the concurrence of the Senate was
asked:

House File 339, a bill for an act relating to snowmobile franchises by requiring the
repurchase of certain inventory upon termination of a franchise and providing effective
and retroactive applicability dates.

Also: That the Senate has on April 2, 2003, passed the following bill in which the
concurrence of the House is asked:

Senate File 372, a bill for an act relating to the licensing of persons providing
money transmission and currency exchange services, providing penalties, and
providing an effective date.

Also: That the Senate has on April 2, 2003, passed the following bill in which the
concurrence of the House is asked:

Senate File 392, a bill for an act relating to the animal agriculture compliance Act,
and providing for penalties.

Also: That the Senate has on April 2, 2003, passed the following bill in which the
concurrence of the House is asked:

Senate File 412, a bill for an act relating to the management of elder group homes.

MICHAEL E. MARSHALL, Secretary

Unfinished Business Calendar

House File 619, a bill for an act relating to health care including
reimbursement of health care facilities based on resident program
eligibility, was taken up for consideration.

Carroll of Poweshiek offered amendment H-1216 filed by Carroll,
et al., as follows:

H-1216

1 Amend House File 619 as follows:
2 1. Page 1, by inserting before line 1, the


3 following:
4 "Section 1. NEW SECTION. 135.131 INTERAGENCY
5 PHARMACEUTICALS BULK PURCHASING COUNCIL.
6 1. For the purposes of this section, "interagency
7 pharmaceuticals bulk purchasing council" or "council"
8 means the interagency pharmaceuticals bulk purchasing
9 council created in this section.
10 2. An interagency pharmaceuticals bulk purchasing
11 council is created within the Iowa department of
12 public health. The department shall provide staff
13 support to the council and the department of
14 pharmaceutical care of the university of Iowa
15 hospitals and clinics shall act in an advisory
16 capacity to the council. The council shall be
17 composed of all of the following members:
18 a. The director of public health, or the
19 director's designee.
20 b. The director of human services, or the
21 director's designee.
22 c. The director of the department of personnel, or
23 the director's designee.
24 d. A representative of the state board of regents.
25 e. The director of the department of corrections,
26 or the director's designee.
27 f. The director, or the director's designee, of
28 any other agency that purchases pharmaceuticals
29 designated to be included as a member by the director
30 of public health.
31 3. The council shall select a chairperson annually
32 from its membership. A majority of the members of the
33 council shall constitute a quorum.
34 4. The council shall do all of the following:
35 a. Develop procedures that member agencies must
36 follow in purchasing pharmaceuticals. However, a
37 member agency may elect not to follow the council's
38 procedures if the agency is able to purchase the
39 pharmaceuticals for a lower price than the price
40 available through the council. An agency that does
41 not follow the council's procedures shall report all
42 of the following to the council:
43 (1) The purchase price for the pharmaceuticals.
44 (2) The name of the wholesaler, retailer, or
45 manufacturer selling the pharmaceuticals.
46 b. Designate a member agency as the central
47 purchasing agency for purchasing of pharmaceuticals.
48 c. Use existing distribution networks, including
49 wholesale and retail distributors, to distribute the
50 pharmaceuticals.

Page 2

1 d. Investigate options that maximize purchasing

2 power, including expanding purchasing under the
3 medical assistance program, qualifying for
4 participation in purchasing programs under 42 U.S.C. §
5 256b, as amended, and utilizing rebate programs,
6 hospital disproportionate share purchasing, multistate
7 purchasing alliances, and health department and
8 federally qualified health center purchasing.
9 e. In collaboration with the department of
10 pharmaceutical care of the university of Iowa
11 hospitals and clinics, make recommendations to member
12 agencies regarding drug utilization review, prior
13 authorization, the use of restrictive formularies, the
14 use of mail order programs, and copayment structures.
15 This paragraph shall not apply to the medical
16 assistance program but only to the operations of the
17 member agencies.
18 5. The central purchasing agency may enter into
19 agreements with a local governmental entity to
20 purchase pharmaceuticals for the local governmental
21 entity.
22 6. The council shall develop procedures under
23 which the council may disclose information relating to
24 the prices manufacturers or wholesalers charge for
25 pharmaceuticals by category of pharmaceutical. The
26 procedure shall prohibit the council from disclosing
27 information that identifies a specific manufacturer or
28 wholesaler or the prices charged by a specific
29 manufacturer or wholesaler for a specific
30 pharmaceutical."
31 2. Page 1, line 11, by inserting after the word
32 "department" the following: "of inspections and
33 appeals, in cooperation with the department of human
34 services,".
35 3. Page 1, by inserting after line 19, the
36 following:
37 "Sec. . NEW SECTION. 155A.4A PHARMACEUTICAL
38 MARKETERS - PROHIBITION OF GIFTS.
39 1. A pharmaceutical marketer shall not offer or
40 provide to any practitioner, hospital, health care
41 facility, pharmacist, health benefit plan
42 administrator, or any other person in this state
43 authorized or licensed to prescribe, dispense,
44 distribute, or purchase prescription drugs, any gift
45 not otherwise exempt under this section.
46 2. The following gifts are exempt from the
47 prohibition of this section:
48 a. Free samples of prescription drugs intended for
49 distribution to patients.
50 b. The payment of reasonable compensation and


Page 3

1 reimbursement of expenses in connection with bona fide
2 clinical trials. As used in this paragraph, "clinical
3 trial" means an approved clinical trial conducted in
4 connection with a research study designed to answer
5 specific questions about vaccines, new therapies, or
6 new ways of utilizing known treatments.
7 c. Any gift, fee, payment, subsidy, or other
8 economic benefit the value of which is less than
9 twenty-five dollars.
10 d. A scholarship or other support for medical
11 students, residents, or fellows to attend a
12 significant educational, scientific, or policymaking
13 conference of a national, regional, or specialty
14 medical or other professional association if the
15 recipient of the scholarship or other support is
16 selected by the association.
17 3. a. Annually on or before January 1, every
18 pharmaceutical manufacturing company shall disclose to
19 the board the value, nature, and purpose of any gift,
20 fee, payment, subsidy, or other economic benefit
21 provided in connection with detailing, promotional, or
22 other marketing activities by the company, directly or
23 through its pharmaceutical marketers, to any
24 practitioner, hospital, health care facility,
25 pharmacist, health benefit plan administrator, or any
26 other person in this state authorized to prescribe,
27 dispense, distribute, or purchase prescription drugs
28 in this state. Disclosure shall be made on a form and
29 in a manner prescribed by the board and shall be made
30 for the period beginning July 1 and ending June 30 of
31 the previous state fiscal year. An initial disclosure
32 shall be made on January 15, 2004, for the period
33 beginning July 1, 2003, and ending December 31, 2003.
34 The board shall provide to the office of the attorney
35 general complete access to the information required to
36 be disclosed under this subsection. The office of the
37 attorney general shall report annually on the
38 disclosures made under this section to the governor
39 and the general assembly on or before March 1.
40 b. Each company subject to the provisions of this
41 section shall also disclose to the board, on or before
42 January 1, 2004, and annually thereafter, the name and
43 address of the individual responsible for the
44 company's compliance with this section.
45 c. The board and the office of the attorney
46 general shall keep confidential all trade secrets as
47 defined in section 550.2. The disclosure form
48 prescribed by the board shall permit the company to
49 identify any information that is a trade secret.
50 d. The company is exempt from disclosure of any

Page 4

1 gifts that are exempt from the prohibition pursuant to
2 subsection 2.
3 e. The attorney general may bring an action for
4 injunctive relief, costs, and attorney fees, and may
5 impose a civil penalty of not more than ten thousand
6 dollars per violation on a company that fails to
7 disclose information as required by this subsection.
8 Each failure to disclose constitutes a separate
9 violation.
10 4. For the purposes of this section:
11 a. "Pharmaceutical manufacturing company" means
12 any entity engaged in the production, preparation,
13 propagation, compounding, conversion, or processing of
14 prescription drugs, either directly or indirectly by
15 extraction from substances of natural origin, or
16 independently by means of chemical synthesis, or by a
17 combination of extraction and chemical synthesis, or
18 any entity engaged in the packaging, repackaging,
19 labeling, relabeling, or distribution of prescription
20 drugs. The term does not include a wholesaler or a
21 pharmacist licensed under this chapter.
22 b. "Pharmaceutical marketer" means a person who,
23 while employed by or under contract to represent a
24 pharmaceutical manufacturing company, engages in
25 pharmaceutical detailing, promotional activities, or
26 other marketing of prescription drugs in this state to
27 any practitioner, hospital, health care facility,
28 pharmacist, health benefit plan administrator, or any
29 other person licensed or authorized to prescribe,
30 dispense, distribute, or purchase prescription drugs.
31 "Pharmaceutical marketer" does not include a
32 wholesaler or a wholesale salesperson.
33 Sec. . NEW SECTION. 249A.20A PREFERRED DRUG
34 LIST PROGRAM.
35 1. The department shall establish and implement a
36 preferred drug list program under the medical
37 assistance program. The department shall submit a
38 medical assistance state plan amendment to the centers
39 for Medicare and Medicaid services of the United
40 States department of health and human services, no
41 later than May 1, 2003, to implement the program.
42 2. A medical assistance pharmaceutical and
43 therapeutics committee shall be established within the
44 department by July 1, 2003, for the purpose of
45 developing and providing ongoing review of the
46 preferred drug list. The committee shall be comprised
47 of members as specified in 42 U.S.C. § 1396r-8,
48 appointed by the governor. The members shall be
49 appointed to terms of two years. Members may be
50 appointed to more than one term. The department shall

Page 5

1 provide staff support to the committee. Committee
2 members shall select a chairperson and vice
3 chairperson annually from the committee membership.
4 3. The pharmaceutical and therapeutics committee
5 shall recommend a preferred drug list to the
6 department. The committee shall develop the preferred
7 drug list by considering each drug's clinically
8 meaningful therapeutic advantages in terms of safety,
9 effectiveness, and clinical outcome. The committee
10 shall use evidence-based research methods in selecting
11 the drugs to be included on the preferred drug list.
12 The committee shall periodically review all drug
13 classes included on the preferred drug list and may
14 amend the list to ensure that the list provides for
15 medically appropriate drug therapies for medical
16 assistance recipients and achieves cost savings to the
17 medical assistance program. The department may
18 procure a sole source contract with an outside entity
19 or contractor to provide professional administrative
20 support to the pharmaceutical and therapeutics
21 committee in researching and recommending drugs to be
22 placed on the preferred drug list.
23 4. Prescribing and dispensing of prescription
24 drugs not included on the preferred drug list shall be
25 subject to prior authorization.
26 5. The preferred drug list program shall provide
27 that if a medical assistance program recipient is
28 being prescribed a mental health-related drug or
29 antiretroviral drug prior to the implementation of the
30 preferred drug list and the prescription drug is not
31 included on the preferred drug list, prescribing and
32 dispensing of the prescription drug is not subject to
33 prior authorization. The preferred drug list program
34 shall also provide that certain prescription drugs for
35 age-related populations that are not included on the
36 preferred drug list are not subject to prior
37 authorization.
38 6. The department may negotiate supplemental
39 rebates from manufacturers that are in addition to
40 those required by Title XIX of the federal Social
41 Security Act. The committee shall consider a product
42 for inclusion on the preferred drug list if the
43 manufacturer provides a supplemental rebate. The
44 department may procure a sole source contract with an
45 outside entity or contractor to conduct negotiations
46 for supplemental rebates.
47 7. The department shall publish and disseminate
48 the preferred drug list to all medical assistance
49 providers in this state.
50 8. Until such time as the pharmaceutical and

Page 6

1 therapeutics committee is operational, the department
2 shall adopt and utilize a preferred drug list
3 developed by a midwestern state that has received
4 approval for its medical assistance state plan
5 amendment from the centers for Medicare and Medicaid
6 services of the United States department of health and
7 human services.
8 9. The department may procure a sole source
9 contract with an outside entity or contactor to
10 participate in a pharmaceutical pooling program with
11 midwestern or other states to provide for an enlarged
12 pool of individuals for the purchase of pharmaceutical
13 products and services for medical assistance
14 recipients.
15 10. The department may adopt administrative rules
16 under section 17A.4, subsection 2, and section 17A.5,
17 subsection 2, paragraph "b", to implement this
18 section.
19 11. Any savings realized under this section may be
20 used to the extent necessary to pay the costs
21 associated with implementation of this section prior
22 to reversion to the medical assistance program. The
23 department shall report the amount of any savings
24 realized and the amount of any costs paid to the
25 chairpersons of the joint appropriations subcommittee
26 on health and human services.
27 Sec. . NEW SECTION. 249A.20B NURSING FACILITY
28 QUALITY ASSURANCE ASSESSMENT.
29 1. The department may assess nursing facilities a
30 quality assurance assessment not to exceed six percent
31 of the total annual revenue of the facility.
32 2. The quality assurance assessment shall be paid
33 to the department in equal monthly amounts on or
34 before the fifteenth day of each month. The
35 department may deduct the monthly assessment amount
36 from medical assistance payments to a nursing
37 facility. The amount deducted from payments shall not
38 exceed the total amount of the fee due.
39 3. Revenue generated from the quality assurance
40 assessment shall be deposited in the senior living
41 trust fund created in section 249H.4. The revenues
42 shall only be used for services for which federal
43 financial participation under the medical assistance
44 program is available to match state funds.
45 4. If federal financial participation to match the
46 assessments made under subsection 1 becomes
47 unavailable under federal law, the department shall
48 terminate the imposition of the assessment beginning
49 on the date that the federal statutory, regulatory, or
50 interpretive change takes effect.

Page 7

1 5. The department may procure a sole source
2 contract to implement the provisions of this section.
3 6. For the purposes of this section, "nursing
4 facility" means nursing facility as defined in section
5 135C.1, excluding residential care facilities and
6 nursing facilities that are operated by the state.
7 7. The department may adopt administrative rules
8 under section 17A.4, subsection 2, and section 17A.5,
9 subsection 2, paragraph "b", to implement this
10 section.
11 Sec. . NEW SECTION. 249A.29A HOME AND
12 COMMUNITY-BASED SERVICES WAIVER - ELIGIBILITY
13 DETERMINATIONS.
14 1. A level of care eligibility determination of an
15 individual seeking approval by the department to
16 receive services under a waiver shall be completed
17 only by a person not participating as a provider of
18 services under a waiver. For the purposes of this
19 section, "provider" and "waiver" mean provider and
20 waiver as defined in section 249A.29.
21 2. Funds appropriated to the department of elder
22 affairs for the purpose of conducting level of care
23 eligibility determinations shall be transferred and
24 made available to the department of human services.
25 3. The department of human services may procure a
26 sole source contract with an outside entity or
27 contractor to conduct level-of-care eligibility
28 determinations.
29 4. The department may adopt administrative rules
30 under section 17A.4, subsection 2, and section 17A.5,
31 subsection 2, paragraph "b", to implement this
32 section.
33 Sec. . Section 249B.3, subsection 1, unnumbered
34 paragraph 1, Code 2003, is amended to read as follows:
35 The department may shall issue a notice
36 establishing and demanding payment of an accrued or
37 accruing spousal support debt due and owing to the
38 department. The notice shall be served upon the
39 community spouse in accordance with the rules of civil
40 procedure. The notice shall include all of the
41 following:
42 Sec. . MEDICAL ASSISTANCE PROGRAM -
43 PHARMACEUTICALS - RECIPIENT REQUIREMENTS.
44 1. The department of human services shall
45 reimburse pharmacy dispensing fees using a single rate
46 of $4.26 per prescription or the pharmacy's usual and
47 customary fee, whichever is lower.
48 2. The department of human services shall require
49 recipients of medical assistance to pay the following
50 copayment on each prescription filled for a covered

Page 8

1 prescription drug, including on each refill of such
2 prescription, as follows:
3 a. A copayment of $1 for each covered generic
4 prescription drug.
5 b. A copayment of 50 cents for each covered brand-
6 name prescription drug for which the cost to the state
7 is $10 or less.
8 c. A copayment of $1 for each covered brand-name
9 prescription drug for which the cost to the state is
10 more than $10 and up to and including $25.
11 d. A copayment of $2 for each covered brand-name
12 prescription drug for which the cost to the state is
13 more than $25 and up to and including $50.
14 e. A copayment of $3 for each covered brand-name
15 prescription drug for which the cost to the state is
16 over $50.
17 3. The department of human services shall
18 establish an ingredient reimbursement basis equal to
19 the average wholesale price minus 12 percent for
20 pharmacy reimbursement for prescription drugs under
21 the medical assistance program.
22 4. a. The department of human services shall
23 continue the sole source contract relative to the
24 state maximum allowable cost (SMAC) program as
25 authorized in 2001 Iowa Acts, chapter 191, section 31,
26 subsection 1, paragraph "b", subparagraph (5). The
27 department shall expand the state maximum allowable
28 cost program for prescription drugs to the greatest
29 extent possible as determined under the contract.
30 b. Pharmacies and providers that are enrolled in
31 the medical assistance program shall make available
32 drug acquisition cost information, product
33 availability information, and other information deemed
34 necessary by the department for the determination of
35 reimbursement rates and the efficient operation of the
36 pharmacy benefit. Pharmacies and providers shall
37 produce and submit the requested information in the
38 manner and format requested by the department or its
39 designee at no cost to the department or designee.
40 Pharmacies and providers shall submit information to
41 the department or its designee within thirty days
42 following receipt of a request for information unless
43 the department or its designee grants an extension
44 upon written request of the pharmacy or provider.
45 c. The state maximum allowable cost shall be
46 established at the average wholesale acquisition cost
47 for a prescription drug and all equivalent products,
48 adjusted by a multiplier of 1.4. The department shall
49 update the state maximum allowable cost every two
50 months, or more often if necessary, to ensure adequate

Page 9

1 product availability.
2 d. The department shall review its current method
3 for determining which prescription drugs are to be
4 included in the SMAC program and shall adjust the
5 method to maximize the cost savings realized through
6 the SMAC program.
7 5. The department of human services shall require
8 recipients of medical assistance to pay a copayment of
9 $3 for each physician office visit.
10 6. The department of human services shall maximize
11 expansion of prior authorization of prescription drugs
12 under the medical assistance program beyond the 25
13 current categories of medications.
14 7. The department of human services shall
15 establish a fixed-fee reimbursement schedule for home
16 health agencies under the medical assistance program.
17 8. The department may adopt emergency rules to
18 implement this section.
19 Sec. . HOME AND COMMUNITY-BASED SERVICES
20 WAIVERS CONSOLIDATION - BUDGET NEUTRALITY. It is the
21 intent of the general assembly that the consolidation
22 of home and community-based services waivers by the
23 department of human services be designed in a manner
24 that does not result in additional cost, with the
25 exception of any services added to the waivers through
26 legislative enactment. The department of human
27 services shall submit an initial report regarding the
28 cost neutrality and status of the waiver consolidation
29 to the legislative fiscal committee no later than
30 January 31, 2004, and a subsequent report no later
31 than July 31, 2004.
32 Sec. . NURSING FACILITY REIMBURSEMENT.
33 Notwithstanding 2001 Iowa Acts, chapter 192, section
34 4, subsection 2, paragraph "c", and subsection 3,
35 paragraph "a", subparagraph (2), if the appropriation
36 provided for reimbursement of nursing facilities for
37 the fiscal year beginning July 1, 2003, is
38 insufficient to reimburse nursing facilities in
39 accordance with the reimbursement rate specified in
40 2001 Iowa Acts, chapter 192, section 4, subsection 2,
41 paragraph "c", the department shall adjust the
42 inflation factor of the reimbursement rate calculation
43 to provide reimbursement within the amount
44 appropriated.
45 Sec. . UTILIZATION MANAGEMENT AND TARGETED
46 AUDITS.
47 1. The department of human services shall conduct
48 ongoing review of recipients and providers of medical
49 assistance services to determine the appropriateness
50 of the scope, duration, and utilization of services.

Page 10

1 If inappropriate usage is identified, the department
2 shall implement procedures necessary to restrict
3 utilization.
4 2. The department of human services shall conduct
5 a review of selected medical assistance services
6 categories and providers for state fiscal years
7 beginning July 1, 2001, July 1, 2002, and July 1,
8 2003. The review shall include intense data analysis
9 to test compliance with rules, regulations, and
10 policies and selected on-site audits.
11 3. The review required under subsection 2 shall
12 attempt to identify any incorrectly paid billings or
13 claims for the state medical assistance program. If
14 inappropriate payments are identified, provider
15 billings shall be adjusted accordingly. If there is
16 substantiated evidence to suggest fraudulent activity,
17 the department shall submit the audit data regarding
18 the medical assistance provider or recipient to the
19 department of inspections and appeals for further
20 action.
21 4. The department of human services may procure a
22 sole source contract to implement the provisions of
23 this section.
24 5. Any savings realized under this section may be
25 used to the extent necessary to pay the costs
26 associated with implementation of this section prior
27 to reversion to the medical assistance program. The
28 department shall report the amount of any savings
29 realized and the amount of any costs paid to the
30 chairpersons of the joint appropriations subcommittee
31 on health and human services.
32 Sec. . MEDICAL ASSISTANCE - CERTAIN PUBLICLY
33 OWNED HOSPITALS - PHYSICIAN SUPPLEMENTAL PAYMENTS.
34 1. For the fiscal year beginning July 1, 2003, and
35 for each fiscal year thereafter, the department of
36 human services shall institute a supplemental payment
37 adjustment applicable to physician services provided
38 to medical assistance recipients at publicly owned
39 acute care teaching hospitals. The adjustment shall
40 generate supplemental payments to physicians which are
41 equal to the difference between the physician's charge
42 and the physician's fee schedule under the medical
43 assistance program. To the extent of the supplemental
44 payments, a qualifying hospital shall, after receipt
45 of the payments, transfer to the department of human
46 services an amount equal to the actual supplemental
47 payments that were made in that month. The department
48 of human services shall deposit these payments in the
49 department's medical assistance account. The
50 department of human services shall amend the medical

Page 11

1 assistance state plan as necessary to implement this
2 section. The department may adopt emergency rules to
3 implement this section.
4 2. The department may use any savings realized
5 under this section to the extent necessary to pay the
6 costs associated with implementation of this section
7 prior to reversion to the medical assistance program.
8 The department shall report the amount of any savings
9 realized and the amount of any costs paid to the
10 chairpersons of the joint appropriations subcommittee
11 on health and human services.
12 Sec. . IOWA CHRONIC CARE CONSORTIUM.
13 1. The department of human services shall
14 aggressively pursue chronic disease management in
15 order to improve care and reduce costs under the
16 medical assistance program.
17 2. The department of human services, in
18 cooperation with the department's fiscal agent and in
19 consultation with a chronic care management resource
20 group, shall profile medical assistance recipients
21 within a select number of disease diagnosis
22 categories. The assessment shall focus on those
23 diagnosis areas that present the greatest opportunity
24 for impact to improved care and cost reduction.
25 3. The department of human services, in
26 consultation with a chronic care management resource
27 group, shall conduct a chronic disease management
28 pilot project for a select number of individuals who
29 are participants in the medical assistance program.
30 The project shall focus on a select number of chronic
31 diseases which may include congestive heart failure,
32 diabetes, and asthma. The initial pilot project shall
33 be implemented by October 1, 2003.
34 4. The department of human services may procure a
35 sole source contract with a vendor to manage
36 individuals with select chronic diseases following the
37 conclusion of the profiling of medical assistance
38 recipients. The management of chronic diseases for
39 individuals under this subsection may be coordinated
40 with the pilot project established in subsection 3.
41 5. The department of human services shall amend
42 the medical assistance state plan and seek any waivers
43 necessary from the centers for Medicare and Medicaid
44 services of the United States department of health and
45 human services to implement this section.
46 6. The department of human services shall submit a
47 progress report regarding chronic disease management
48 measures undertaken pursuant to this section to the
49 governor and the general assembly by November 1, 2003.
50 The report shall include recommendations regarding

Page 12

1 incorporating chronic disease management programming
2 into the medical assistance system and the potential
3 improvements in care and reductions in costs that may
4 be obtained through chronic disease management.
5 7. The department of human services may adopt
6 emergency rules to implement this section.
7 8. Any savings realized under this section may be
8 used as necessary to pay the costs associated with
9 implementation of this section prior to reversion to
10 the medical assistance program. The department shall
11 report the amount of any savings realized and the
12 amount of any costs paid to the chairpersons of the
13 joint appropriations subcommittee on health and human
14 services.
15 Sec. . EFFECTIVE DATES.
16 1. The section of this Act enacting section
17 249A.20A takes effect upon enactment.
18 2. The section of this Act enacting section
19 249A.20B, being deemed of immediate importance, takes
20 effect upon enactment.
21 3. The section of this Act relating to physician
22 supplemental payments at certain publicly owned
23 hospitals, being deemed of immediate importance, takes
24 effect upon enactment.
25 4. The section of this Act relating to chronic
26 disease management, being deemed of immediate
27 importance, takes effect upon enactment."
28 4. Title page, line 2, by inserting after the
29 word "eligibility" the following: "and providing
30 effective dates".
31 5. By renumbering as necessary.

Carroll of Poweshiek offered the following amendment H-1250, to
amendment H-1216, filed by him from the floor and requested
division as follows:

H-1250

1 Amend the amendment, H-1216, to House File 619 as
2 follows:

H-1250A

3 1. By striking page 2, line 37, through page 4,
4 line 32.
5 2. By striking page 4, line 42, through page 5,
6 line 3, and inserting the following:
7 "2. a. a medical assistance pharmaceutical and
8 therapeutics committee shall be established within the

9 department by July 1, 2003, for the purpose of
10 developing and providing ongoing review of the
11 preferred drug list.
12 b. (1) The members of the committee shall be
13 appointed by the governor and shall include health
14 care professionals who possess recognized knowledge
15 and expertise in one or more of the following:
16 (a) The clinically appropriate prescribing of
17 covered outpatient drugs.
18 (b) The clinically appropriate dispensing and
19 monitoring of covered outpatient drugs.
20 (c) Drug use review, evaluation, and intervention.
21 (d) Medical quality assurance.
22 (2) The membership of the committee shall be
23 comprised of at least one third but not more than
24 fifty-one percent licensed and actively practicing
25 physicians and at least one third licensed and
26 actively practicing pharmacists.
27 c. The members shall be appointed to terms of two
28 years. Members may be appointed to more than one
29 term. The department shall provide staff support to
30 the committee. Committee members shall select a
31 chairperson and vice chairperson annually from the
32 committee membership."

H-1250B

33 3. Page 5, by striking lines 27 through 29, and
34 inserting the following: "that if a medical
35 assistance program recipient was prescribed a mental
36 health-related drug, an antiretroviral drug, or a drug
37 related to the treatment of transplantation or cancer,
38 prior to the implementation of the".

H-1250A

39 4. Page 6, by striking lines 25 and 26, and
40 inserting the following: "legislative fiscal
41 committee on a quarterly basis."
42 5. Page 9, by inserting after line 6 the
43 following:
44 "e. The department shall report any savings
45 realized through the SMAC program to the legislative
46 fiscal committee on a monthly basis."
47 6. Page 9, by striking lines 35 through 38, and
48 inserting the following: "paragraph "a", subparagraph
49 (2), if projected state fund expenditures for
50 reimbursement of nursing facilities for the fiscal

Page 2

H-1250A

1 year beginning July 1, 2003, in".

H-1250A

2 7. Page 9, line 41, by inserting before the words
3 "the department" the following: "exceeds
4 $147,252,856,".
5 8. Page 9, by striking line 44, and inserting the
6 following: "projected."
7 9. Page 11, by inserting after line 11 the
8 following:
9 "3. The department of human services shall, in any
10 compilation of data or other report distributed to the
11 public concerning payments to providers under the
12 medical assistance program, set forth reimbursements
13 to physicians of the university of Iowa college of
14 medicine through supplemental adjustments as a
15 separate item and shall not include such payments in
16 the amounts otherwise reported as the reimbursement to
17 a physician for services to medical assistance
18 recipients."
19 10. Page 12, by inserting after line 20, the
20 following:
21 "___. The portion of the section of this Act
22 relating to the state maximum allowable cost (SMAC)
23 program, being deemed of immediate importance, takes
24 effect upon enactment."

The House stood at ease at 5:27 p.m., until the fall of the gavel.

The House resumed session at 6:22 p.m., Speaker Rants in the
chair.

Further division was requested as follows:

H-1250A - Page 1 lines 5 through 32 and page 1 lines 39 through
50, page 2 lines 2 through 24.
H-1250B - Page 1 lines 11 through 38.
H-1250C - Page 1 lines 3 and 4.

Carroll of Poweshiek moved the adoption of amendment H-1250A,
to amendment H-1216.

Amendment H-1250A was adopted.

Carroll of Poweshiek moved the adoption of amendment H-1250C
to amendment H-1216.

A non-record roll call was requested.

The ayes were 50, nays 36.

Amendment H-1250C was adopted.

Jochum of Dubuque offered the following amendment H-1251, to
amendment H-1216, filed by her from the floor and moved its
adoption:

H-1251

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 4, by inserting before line 33, the
4 following:
5 "Sec. . NEW SECTION. 155B.1 SHORT TITLE.
6 This chapter shall be known and may be cited as the
7 "Pharmacy Benefits Manager Regulation Act".
8 Sec. . NEW SECTION. 155B.2 PURPOSE AND
9 INTENT.
10 The purposes of this chapter are:
11 1. To establish standards and criteria for the
12 regulation and licensing of pharmacy benefits
13 managers.
14 2. To promote, preserve, and protect the public
15 health, safety, and welfare by and through effective
16 regulation and licensing of pharmacy benefits
17 managers.
18 Sec. . NEW SECTION. 155B.3 DEFINITIONS.
19 For purposes of this chapter, unless the context
20 otherwise requires:
21 1. "Board of pharmacy" or "board" means the board
22 of pharmacy examiners.
23 2. "Cease and desist order" means an order of the
24 board prohibiting a pharmacy benefits manager or other
25 person from continuing a particular course of conduct
26 which violates this chapter or the rules adopted under
27 this chapter.
28 3. "Commissioner" means the commissioner of
29 insurance.
30 4. "Enrollee" means an individual who is enrolled
31 in a pharmacy benefits management plan.
32 5. "Health insurance plan or contract" means a
33 third-party payment provider contract or policy that
34 is an individual or group policy of accident or health
35 insurance or individual or group hospital or health
36 care services contract issued pursuant to chapter 509,
37 509A, 514, or 514A, or an individual or group health
38 maintenance organization contract issued and regulated
39 under chapter 514B.
40 6. "Insolvent" or "insolvency" means a financial

41 situation in which, based upon the financial
42 information required by this chapter for the
43 preparation of a pharmacy benefits manager's annual
44 statement, the assets of the pharmacy benefits manager
45 are less than the sum of all the company's liabilities
46 and required reserves.
47 7. "Maintenance drug" means a drug prescribed by a
48 practitioner who is licensed to prescribe drugs and
49 used to treat a medical condition for a period of more
50 than thirty days.

Page 2

1 8. "Multisource drug" means a drug that is stocked
2 and is available from three or more suppliers.
3 9. "Pharmacist" means pharmacist as defined in
4 section 155A.3.
5 10. "Pharmacists' services" include drug therapy
6 and other patient care services provided by a licensed
7 pharmacist intended to achieve outcomes related to the
8 cure or prevention of a disease, elimination or
9 reduction of a patient's symptoms, or arresting or
10 slowing of a disease process as defined by rule of the
11 board.
12 11. "Pharmacy" means pharmacy as defined in
13 section 155A.3.
14 12. "Pharmacy benefits management plan" means an
15 arrangement for the delivery of prescription services
16 in which a pharmacy benefits manager provides,
17 arranges for, pays for, or reimburses any of the costs
18 of prescription services for an enrollee on a prepaid
19 or insured basis which provides all of the following:
20 a. Contains one or more incentive arrangements
21 intended to influence the cost or level of
22 prescription services between the plan sponsor and one
23 or more pharmacies with respect to the delivery of
24 prescription services.
25 b. Requires or creates benefit payment
26 differential incentives for enrollees to use under
27 contract with the pharmacy benefits manager.
28 "Pharmacy benefits management plan" does not mean
29 an employee welfare benefit plan as defined in the
30 federal Employee Retirement Income Security Act of
31 1974, 29 U.S.C. § 1002(1), which is self-insured or
32 self-funded.
33 13. "Pharmacy benefits manager" or "company" means
34 an entity that administers the prescription drug or
35 device portion of a health insurance plan or contract
36 on behalf of the sponsors of the health insurance plan
37 or contract.
38 14. "Plan sponsor" means an employer, insurance
39 company, union, or health maintenance organization

40 that contracts with a pharmacy benefits manager for
41 delivery of prescription services.
42 15. "Usual and customary price" means the price
43 the pharmacist would have charged a cash-paying
44 patient for the same services on the same date
45 inclusive of any discounts applicable.
46 Sec. . NEW SECTION. 155B.4 CERTIFICATE OF
47 AUTHORITY.
48 1. A person shall not establish or operate as a
49 pharmacy benefits manager in this state to provide
50 pharmacy benefits management plans without first

Page 3

1 obtaining a certificate of authority from the board of
2 pharmacy examiners. A pharmacy benefits manager
3 providing pharmacy benefits management plans in this
4 state shall obtain a certificate of authority from the
5 board every four years.
6 2. A person may apply to the board to obtain a
7 certificate of authority to establish and operate as a
8 pharmacy benefits manager in compliance with this
9 chapter if the person obtains an annual license to do
10 business in this state from the commissioner under
11 section 155B.5.
12 3. The board may suspend or revoke a certificate
13 of authority issued to a pharmacy benefits manager
14 under this chapter or may deny an application for a
15 certificate of authority if the board finds any of the
16 following:
17 a. The pharmacy benefits manager is operating
18 significantly in contravention of its basic
19 organizational document.
20 b. The pharmacy benefits manager does not arrange
21 for pharmacists' services.
22 c. The pharmacy benefits manager has failed to
23 meet the requirements for issuance of a certificate of
24 authority established in this chapter.
25 d. The pharmacy benefits manager is unable to
26 fulfill its obligation to furnish pharmacists'
27 services as required under its pharmacy benefits
28 management plan.
29 e. The pharmacy benefits manager is no longer
30 financially responsible and may reasonably be expected
31 to be unable to meet its obligations to enrollees or
32 prospective enrollees.
33 f. The pharmacy benefits manager, or any person on
34 the company's behalf, has advertised or merchandised
35 its services in an untrue, misrepresentative,
36 misleading, deceptive, or unfair manner.
37 g. The continued operation of the pharmacy
38 benefits manager would be hazardous to its enrollees.

39 h. The pharmacy benefits manager has failed to
40 file an annual statement with the commissioner in a
41 timely manner.
42 i. The pharmacy benefits manager has otherwise
43 failed to substantially comply with this chapter.
44 4. When the certificate of authority of a pharmacy
45 benefits manager is revoked, the company shall
46 proceed, immediately following the effective date of
47 the order of revocation, to conclude the company's
48 affairs and shall conduct no further business except
49 as may be essential to the orderly conclusion of the
50 affairs of the company. The board may permit further

Page 4

1 operation of the company as the board may find to be
2 in the best interest of enrollees so that the
3 enrollees will be afforded the greatest practical
4 opportunity to obtain pharmacists' services.
5 Sec. . NEW SECTION. 155B.5 LICENSE TO DO
6 BUSINESS.
7 1. The commissioner shall not issue an annual
8 license to do business in this state to any pharmacy
9 benefits manager providing pharmacy benefits
10 management plans until the commissioner is satisfied
11 that the pharmacy benefits manager has complied with
12 all of the following:
13 a. Paid all fees, taxes, and charges required by
14 law.
15 b. Has made any deposit required by this chapter.
16 c. Has met the minimum capital and surplus
17 requirements specified by the commissioner.
18 d. Has filed any necessary financial statement and
19 any reports, certificates, or other documents the
20 commissioner considers necessary to secure a full and
21 accurate knowledge of the company's affairs and
22 financial condition.
23 e. Is solvent, and the company's financial
24 condition, method of operation, and manner of doing
25 business satisfy the commissioner that the company can
26 meet the company's obligations to all enrollees.
27 f. Has otherwise complied with all the
28 requirements of law.
29 2. The license shall be in addition to the
30 certificate of authority required by the board. A
31 nonrefundable license application fee of five hundred
32 dollars shall accompany each application for a license
33 to transact business in this state. The fee shall be
34 collected by the commissioner and shall be deposited
35 in the pharmacy benefits manager fund created in
36 section 155B.16.
37 3. The license shall be signed by the commissioner

38 or the commissioner's agent and shall expire on the
39 next June 30 after the date on which the license
40 becomes effective.
41 4. A pharmacy benefits manager providing pharmacy
42 benefits management plans shall obtain an annual
43 renewal of the company's license from the
44 commissioner. The commissioner may refuse to renew
45 the license of any pharmacy benefits manager or may
46 renew the license, subject to any restrictions
47 considered appropriate by the commissioner, if the
48 commissioner finds an impairment of required capital
49 and surplus, or if the commissioner finds that the
50 pharmacy benefits manager has not satisfied all the

Page 5

1 conditions specified in this chapter. The
2 commissioner shall not fail to renew the license of
3 any pharmacy benefits manager to transact business in
4 this state without providing the pharmacy benefits
5 manager ten days' notice and providing the company an
6 opportunity to be heard. The hearing may be informal,
7 and the commissioner and the pharmacy benefits manager
8 may waive the required notice.
9 Sec. . NEW SECTION. 155B.6 ANNUAL STATEMENT.
10 1. A pharmacy benefits manager providing pharmacy
11 management benefits plans in this state shall file a
12 statement with the commissioner annually by March 1.
13 The statement shall be verified by at least two
14 principal officers of the pharmacy benefits manager
15 and shall cover the preceding calendar year. The
16 pharmacy benefits manager shall also submit a copy of
17 the statement to the board.
18 2. The statement shall be on forms prescribed by
19 the commissioner and shall include all of the
20 following:
21 a. A financial statement of the company, including
22 its balance sheet and income statement for the
23 preceding year.
24 b. The number of persons enrolled during the year,
25 the number of enrollees as of the end of the year, and
26 the number of enrollments terminated during the year.
27 c. Any other information relating to the
28 operations of the pharmacy benefits manager required
29 by the commissioner pursuant to this chapter.
30 3. If the pharmacy benefits manager is audited
31 annually by an independent certified public
32 accountant, a copy of the certified audit report shall
33 be filed annually with the commissioner by June 30.
34 4. The commissioner may extend the time prescribed
35 for any pharmacy benefits manager for filing an annual
36 statement or other reports, or exhibits of the

37 statement or report for good cause shown. However,
38 the commissioner shall not extend the time for filing
39 annual statements beyond sixty days after the time
40 prescribed by subsection 1. A pharmacy benefits
41 manager which fails to file its annual statement
42 within the time prescribed by this section may have
43 its licensed revoked by the commissioner or its
44 certificate of authority revoked or suspended by the
45 board until the annual statement is filed. The
46 commission may waive the requirements for a pharmacy
47 benefits manager to file financial information if an
48 affiliate of the pharmacy benefits manager is also
49 required to file the same information.
50 Sec. . NEW SECTION. 155B.7 FINANCIAL

Page 6

1 EXAMINATION.
2 1. In lieu of or in addition to performing a
3 financial examination of a pharmacy benefits manager,
4 the commissioner may accept the report of a financial
5 examination by another person responsible for pharmacy
6 benefits managers under the laws of another state who
7 is certified by the insurance supervisory official,
8 similar regulatory agency, or the state health
9 commissioner of the other state.
10 2. The commissioner shall coordinate financial
11 examinations of pharmacy benefits managers that
12 provide pharmacy management benefits plans in this
13 state to ensure an appropriate level of regulatory
14 oversight and to avoid any undue duplication of effort
15 or regulation. The pharmacy benefits manager being
16 examined shall pay the cost of the examination.
17 Payments of the cost of the examination shall be
18 collected by the commissioner and shall be deposited
19 in the pharmacy benefits manager fund created in
20 section 155B.16.
21 Sec. . NEW SECTION. 155B.8 ASSESSMENT.
22 1. The expense of administering this chapter,
23 including the costs incurred by the commissioner and
24 the board, shall be assessed annually by the board
25 against all pharmacy benefits managers operating in
26 this state. Before determining the assessment, the
27 board shall request from the commissioner an estimate
28 of all expenses for the regulation, supervision, and
29 examination of all companies subject to regulation
30 under this chapter. The assessment shall be in
31 proportion to the business done in this state.
32 2. Assessments shall be collected by the
33 commissioner and shall be deposited in the pharmacy
34 benefits manager fund created in section 155B.16.
35 3. The board shall provide each pharmacy benefits

36 manager notice of the assessment, which shall be paid
37 to the board on or before March 1 of each year. A
38 pharmacy benefits manager that fails to pay the
39 assessment on or before the date prescribed shall be
40 subject to a penalty imposed by the board which is ten
41 percent of the assessment and interest for the period
42 between the due date and the date of full payment. If
43 a payment is made in an amount later found to be in
44 error, the following shall apply:
45 a. If the error found is an underpayment and an
46 additional amount is due, the commission shall notify
47 the company of the additional amount and the company
48 shall pay the additional amount within fourteen days
49 of the date of the notice.
50 b. If the error found is an overpayment, a refund

Page 7

1 shall be ordered.
2 4. If an assessment made under this chapter is not
3 paid to the board by the prescribed date, the amount
4 of the assessment, penalty, and interest may be
5 recovered from the defaulting company on motion of the
6 board made in the name and for the use of the state in
7 the appropriate court after ten days' notice to the
8 company. The certificate of authority of a defaulting
9 company to transact business in this state may be
10 revoked or suspended by the board until the company
11 has paid the assessment.
12 Sec. . NEW SECTION. 155B.9 PHARMACY BENEFITS
13 MANAGER CONTRACTS.
14 1. A pharmacy benefits manager that contracts with
15 a pharmacy or pharmacist to provide pharmacists'
16 services through a pharmacy management plan for
17 enrollees in this state shall file the contract with
18 the board thirty days before the execution of the
19 contract. The contract shall be deemed approved
20 unless the board disapproves the contract within
21 thirty days after the contract is filed with the
22 board.
23 2. Disapproval of the contract shall be in
24 writing, stating the reasons for the disapproval, and
25 a copy of the written disapproval shall be delivered
26 to the pharmacy benefits manager.
27 3. The board, consistent with the board's
28 responsibility for protecting the public interest,
29 shall develop formal criteria for the approval and
30 disapproval of pharmacy benefits manager contracts.
31 4. The pharmacy benefits manager shall provide a
32 contract to the pharmacy or pharmacist that is written
33 in plain language that is generally understood by
34 pharmacists.

35 5. A pharmacy benefits manager that contracts with
36 a pharmacy or pharmacist to provide pharmacist
37 services through a pharmacy benefits management plan
38 for enrollees in this state on behalf of any health
39 plan sponsors shall be identified as the agent of the
40 health plan sponsor. The health plan fiduciary
41 responsibilities shall transfer to the contracting
42 pharmacy benefits manager.
43 6. A contract shall apply the same coinsurance,
44 copayment, and deductible to covered drug
45 prescriptions filled by any pharmacy or pharmacist who
46 participates in the network.
47 7. This section shall not be construed to prohibit
48 a contract from applying different coinsurance,
49 copayment, and deductible factors between generic and
50 brand-name drugs that an enrollee may obtain with a

Page 8

1 prescription if the limits are applied uniformly to
2 all pharmacies or pharmacists in the health insurance
3 plan or contract network.
4 8. A pharmacy benefits management plan shall not
5 require a pharmacy or pharmacist to change an
6 enrollee's maintenance drug unless the prescribing
7 physician and the enrollee agree to the change.
8 9. A pharmacy's or pharmacist's participation in
9 any plan or network offered by a pharmacy benefits
10 manager is optional and at the discretion of the
11 pharmacy or pharmacist. The pharmacy's or
12 pharmacist's participation or lack of participation in
13 one plan shall not affect the pharmacy's or
14 pharmacist's participation in any other plan or
15 network ordered by the pharmacy benefits manager.
16 10. A pharmacy benefits manager that initiates an
17 audit of a pharmacy or pharmacist under the provisions
18 of the contract shall limit the methods and procedures
19 that are recognized as fair and equitable for both the
20 pharmacy benefits manager and the pharmacy or
21 pharmacist. An audit shall not allow for
22 extrapolation calculations. A pharmacy benefits
23 manager shall not recoup any moneys due from an audit
24 by setoff from future remittances until the results of
25 the audit are resolved and finalized by both the
26 pharmacy benefits manager and the pharmacy or
27 pharmacist. If the findings of an audit cannot be
28 finalized and agreed to by both parties, the
29 commissioner shall establish an independent review
30 board to adjudicate unresolved grievances.
31 11. a. Prior to terminating a pharmacy or
32 pharmacist from the network, a pharmacy benefits
33 manager shall provide the pharmacy or pharmacist with

34 a written explanation of the reason for the
35 termination at least thirty days before the actual
36 termination unless the contract termination action is
37 taken as the result of any of the following:
38 (1) Loss of the pharmacy's or pharmacist's license
39 to practice pharmacy or loss of professional liability
40 insurance.
41 (2) Conviction of fraud or misrepresentation in
42 regard to the contract.
43 b. A pharmacy or pharmacist may request and
44 receive, within thirty days, a review of the proposed
45 termination by the board prior to the termination.
46 12. The pharmacy or pharmacist shall not be held
47 responsible for actions of the pharmacy benefits
48 manager or plan sponsors and the pharmacy benefits
49 manager or plan sponsors shall not be held responsible
50 for the actions of the pharmacy or pharmacist.

Page 9

1 Sec. . NEW SECTION. 155B.10 ENFORCEMENT.
2 1. The board shall develop formal investigation
3 and compliance procedures for responding to complaints
4 by health insurance plans or contract sponsors,
5 pharmacists, or enrollees concerning the failure of a
6 pharmacy benefits manager to comply with this chapter.
7 If, based upon an investigation or complaint, the
8 board has reason to believe that there is a violation
9 of this chapter, the board shall issue and serve upon
10 the pharmacy benefits manager concerned a statement of
11 the charges and a notice of a hearing to be held at a
12 time and place fixed in the notice, which shall not be
13 less than thirty days after notice is served. The
14 notice shall require the pharmacy benefits manager to
15 show cause why an order should not be issued directing
16 the company to cease and desist from the violation.
17 At the hearing, the pharmacy benefits manager shall
18 have an opportunity to be heard and to show cause why
19 an order should not be issued requiring the pharmacy
20 benefits manager to cease and desist from the
21 violation.
22 2. The board may perform an examination concerning
23 the quality of services of any pharmacy benefits
24 manager and providers with whom the pharmacy benefits
25 manager has contracts, agreements, or other
26 arrangements pursuant to its pharmacy benefits
27 management plan as often as the board deems necessary
28 for the protection of the interests of the people of
29 this state. The pharmacy benefits manager being
30 examined shall pay the cost of the examination.
31 Sec. . NEW SECTION. 155B.11 PRESCRIPTION DRUG
32 REIMBURSEMENT COSTS.

33 Pharmacy benefits managers shall use a current and
34 nationally recognized benchmark on which to base
35 reimbursements for prescription drugs and products
36 dispensed by pharmacies and pharmacists as follows:
37 1. For brand-name, single-source products, the
38 average wholesale price as listed in first data bank
39 or facts and comparisons correct and current on the
40 date the service was provided shall be used as the
41 index.
42 2. For generic drug, multisource products, maximum
43 allowable cost shall be established by referencing
44 first data bank facts and comparisons baseline prices.
45 Only products that are compliant with pharmacy laws as
46 equivalent and generically interchangeable with a
47 federal food and drug administration orange book
48 rating of "A-B" shall be reimbursed from a maximum
49 allowable cost price methodology. In the event a
50 multisource product has no baseline price, the product

Page 10

1 shall be treated as a single-source branded drug for
2 the purpose of valuing reimbursement.
3 Sec. . NEW SECTION. 155B.12 PROHIBITED
4 PRACTICES.
5 1. A pharmacy benefits manager or its
6 representative shall not cause or knowingly permit any
7 of the following:
8 a. The use of advertising that is untrue or
9 misleading.
10 b. Solicitation that is untrue or misleading.
11 c. Any form of evidence of coverage that is
12 deceptive.
13 2. A pharmacy benefits manager, unless licensed as
14 an insurer, shall not use in its name, contracts, or
15 literature any of the following:
16 a. Any form of the word "insurance", "casualty",
17 "surety", or "mutual".
18 b. Any other words descriptive of the insurance,
19 casualty, or surety business, or deceptively similar
20 to the name or description of any insurer or fidelity
21 and surety insurer, doing business in this state.
22 3. A pharmacy benefits manager shall not
23 discriminate on the basis of race, creed, color, sex,
24 or religion in the selection of pharmacies or
25 pharmacists with whom the company does business.
26 4. A pharmacy benefits manager shall not unfairly
27 discriminate against pharmacists when contracting for
28 pharmacists' services.
29 5. A pharmacy benefits manager shall be entitled
30 access to usual and customary pricing only for
31 comparison to the reimbursement of a specific claims

32 payment made by the pharmacy benefits manager. Usual
33 and customary pricing is confidential and a pharmacy
34 benefits manager is prohibited from any other use or
35 disclosure of usual and customary pricing.
36 6. A pharmacy benefits manager shall not move a
37 plan to another payment network unless the pharmacy
38 benefits manager receives written consent from the
39 plan sponsor.
40 7. A pharmacy benefits manager shall not receive
41 or accept any rebate, kickback, or any special payment
42 or favor or advantage of any valuable consideration or
43 inducement for changing a patient's drug product
44 unless the change is specified in a written contract
45 that has been filed with the commissioner at least
46 thirty days prior to the execution of the contract.
47 8. A claim paid by a pharmacy benefits manager
48 shall not be retroactively denied or adjusted after
49 seven days from adjudication of the claim.
50 Acknowledgement of eligibility shall not be

Page 11

1 retroactively reversed. A pharmacy benefits manager
2 may retroactively deny or adjust a claim only if the
3 original claim was submitted fraudulently, the
4 original claim payment was incorrect because the
5 provider was previously paid for services rendered, or
6 the services were not rendered by the pharmacist.
7 9. A pharmacy benefits manager shall not terminate
8 a pharmacy from a network based on any of the
9 following:
10 a. The pharmacy expresses disagreement with the
11 pharmacy benefits manager's decision to deny or limit
12 benefits to an enrollee.
13 b. A pharmacist employed by the pharmacy discusses
14 with a current, former, or prospective enrollee any
15 aspect of the person's medical condition or treatment
16 alternatives whether or not the service is a covered
17 service.
18 c. A pharmacist employed by the pharmacy makes a
19 personal recommendation regarding selecting a pharmacy
20 benefits manager based on the pharmacist's personal
21 knowledge of the health needs of the individual.
22 d. The pharmacy protests or expresses disagreement
23 with a medical decision, medical policy, or medical
24 practice of a pharmacy benefits manager.
25 e. The pharmacy has in good faith communicated
26 with or advocated on behalf of one or more of the
27 pharmacy's current, former, or prospective enrollees
28 regarding the provisions, terms, or requirements of
29 the pharmacy benefits manager's health benefit plans
30 as they relate to the needs of the individual

31 regarding the method by which the pharmacy is
32 compensated for services provided under the agreement
33 with the pharmacy benefits manager.
34 10. A pharmacy benefits manager shall not
35 terminate a pharmacy from a network or otherwise
36 penalize a pharmacy solely because of the pharmacy's
37 invoking of the pharmacy's right under the contract or
38 applicable law or regulation.
39 11. A pharmacy benefits manager's termination due
40 to incompetence or unprofessional behavior shall not
41 release the pharmacy benefits manager from the
42 obligation to make any payment due to the pharmacy for
43 services provided in special circumstances post-
44 termination to the enrollees at less than agreed-upon
45 rates.
46 12. Participation or lack of participation by a
47 pharmacy in a plan or network shall not affect
48 participation in any other plan or network offered by
49 a pharmacy benefits manager.
50 Sec. . NEW SECTION. 155B.13 DISCLOSURES.

Page 12

1 1. The following shall be provided to the pharmacy
2 benefits manager enrollees at the time of enrollment
3 or at the time the contract is issued and shall be
4 made available upon request or at least annually:
5 a. A list of the names and locations of all
6 affiliated pharmacists' services providers.
7 b. A description of the service area or areas
8 within which the pharmacy benefits manager provides
9 prescription services.
10 c. A description of the method of resolving
11 complaints of enrollees, including a description of
12 any arbitration procedure if complaints may be
13 resolved through a specified arbitration agreement.
14 d. Notice that the pharmacy benefits manager is
15 subject to regulation in this state by both the board
16 of pharmacy examiners and the commissioner of
17 insurance.
18 e. A prominent notice included within the evidence
19 of coverage, providing substantially the following:
20 "If you have any questions regarding an appeal or
21 grievance concerning the pharmacists' services that
22 you have been provided, which have not been
23 satisfactorily addressed by your plan, you may contact
24 the board of pharmacy examiners." The notice shall
25 also provide the toll-free telephone number, mailing
26 address, and electronic mail address of the board of
27 pharmacy examiners.
28 2. Any disclosure from a pharmacy benefits manager
29 to enrollees shall be written plainly, using terms

30 generally understood by the general public and a copy
31 of the disclosure shall be provided to all pharmacies
32 that are members of the network.
33 Sec. . NEW SECTION. 155B.14 PRIVACY.
34 An enrollee has the right to privacy and
35 confidentiality in the provision of pharmacists'
36 services. This right may be expressly waived in
37 writing by the enrollee or the enrollee's guardian.
38 Sec. . NEW SECTION. 155B.15 INSOLVENCY.
39 1. If a pharmacy benefits manager becomes
40 insolvent or ceases to be a company in this state in
41 any assessable or license year, the company shall
42 remain liable for the payment of the assessment for
43 the period in which the company operated as a pharmacy
44 benefits manager in this state.
45 2. If a pharmacy benefits manager becomes
46 insolvent, the commissioner may, after notice and
47 hearing, levy an assessment, in addition to an
48 assessment pursuant to section 155B.8, on pharmacy
49 benefits managers licensed to do business in this
50 state. The assessments shall be paid quarterly to the

Page 13

1 commissioner, and upon receipt by the commissioner
2 shall be paid over into an escrow account in the
3 pharmacy benefits manager fund. The escrow account
4 shall be used solely for the benefit of enrollees of
5 the insolvent pharmacy benefits manager.
6 Sec. . NEW SECTION. 155B.16 PHARMACY BENEFITS
7 MANAGER FUND - USES - ESCROW ACCOUNT.
8 1. A pharmacy benefits manager fund is created in
9 the state treasury under the authority of the
10 commissioner of insurance. Moneys received from
11 licensure of pharmacy benefits managers pursuant to
12 section 155B.5, from examinations collected pursuant
13 to section 155B.7, and from assessments collected
14 pursuant to section 155B.8 shall be deposited in the
15 fund. Moneys in the fund shall be used and an amount
16 necessary is appropriated, annually, to the division
17 of insurance of the department of commerce for the
18 purposes of enforcing this chapter.
19 2. An escrow account is created in the pharmacy
20 benefits manager fund. Assessments collected pursuant
21 to section 155B.15 shall be deposited in the account
22 and are appropriated to the division of insurance of
23 the department of commerce to be used solely for the
24 benefit of the enrollees of an insolvent pharmacy
25 benefits manager."
26 2. By renumbering as necessary.


Roll call was requested by Myers of Johnson and Stevens of
Dickinson.

Rule 75 was invoked.

On the question "Shall amendment H-1251 be adopted?" (H.F. 619)

The ayes were, 45:
Bell Berry Bukta Cohoon
Dandekar Davitt Fallon Foege
Ford Frevert Gaskill Greimann
Heddens Hogg Hunter Huser
Jochum Kuhn Lensing Lykam
Mascher McCarthy Mertz Miller
Murphy Myers Oldson Olson, D.
Osterhaus Petersen Quirk Reasoner
Shoultz Smith Stevens Struyk
Swaim Taylor, D. Taylor, T. Thomas
Wendt Whitaker Whitead Winckler
Wise

 


The nays were, 54:
Alons Arnold Baudler Boal
Boddicker Boggess Carroll Chambers
De Boef Dennis Dix Dolecheck
Drake Eichhorn Elgin Freeman
Gipp Granzow Greiner Hahn
Hansen Hanson Heaton Hoffman
Horbach Huseman Hutter Jacobs
Jenkins Jones Klemme Kramer
Kurtenbach Lalk Lukan Maddox
Manternach Olson, S. Paulsen Raecker
Rasmussen Rayhons Roberts Sands
Schickel Tjepkes Tymeson Upmeyer
Van Engelenhoven Van Fossen, J.K. Van Fossen, J.R. Watts
Wilderdyke Mr. Speaker
Rants

 


Absent or not voting, 1:
Connors Amendment H-1251 lost.

 



LEAVE OF ABSENCE

Leave of absence was granted as follows:

Connors of Polk on request of Myers of Johnson.

Jenkins of Black Hawk in the chair at 6:58 p.m.

Smith of Marshall asked and received unanimous consent that
amendment H-1225 to amendment H-1216, be deferred.

Carroll of Poweshiek asked and received unanimous consent to
withdraw amendment H-1250B, to amendment H-1216.

Carroll of Poweshiek offered the following amendment H-1257, to
amendment H-1216, filed by him from the floor and moved its
adoption:

H-1257

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 5, line 23, by striking the word
4 "Prescribing" and inserting the following: "With the
5 exception of drugs prescribed for the treatment of
6 human immunodeficiency virus or acquired immune
7 deficiency syndrome, transplantation, or cancer and
8 drugs prescribed for mental illness with the exception
9 of drugs and drug compounds that do not have a
10 significant variation in a therapeutic profile or side
11 affect profile within a therapeutic class,
12 prescribing".
13 2. Page 5, by striking lines 26 through 37.
14 3. By renumbering as necessary.

Amendment H-1257 was adopted, placing out of order amendment
H-1225, to amendment H-1216, previously deferred, filed by Smith of
Marshall from the floor.

Carroll of Poweshiek offered the following amendment H-1236, to
amendment H-1216, filed by him from the floor and moved its
adoption:

H-1236

1 Amend the amendment, H-1216, to House File 619 as
2 follows:

3 1. Page 6, by inserting after line 31, the
4 following:
5 "1A. The department of human services shall submit
6 a medical assistance state plan amendment to the
7 centers for Medicare and Medicaid services of the
8 United States department of health and human services
9 to effectuate the nursing facility quality assurance
10 assessment.
11 1B. The department of human services shall submit
12 an application to the secretary of the United States
13 department of health and human services to request a
14 waiver of the uniform tax requirement pursuant to 42
15 U.S.C. § 1396b(w)(3)(E) and 42 C.F.R. § 433.68(e)(2)."
16 2. Page 12, by inserting after line 14, the
17 following:
18 "Sec. . CONTINGENT EFFECTIVE DATE.
19 1. Section 249A.20B, as enacted in this Act, shall
20 not take effect unless the department of human
21 services receives approval of both the medical
22 assistance state plan amendment from the centers for
23 Medicare and Medicaid services of the United States
24 department of health and human services to effectuate
25 the nursing facility quality assurance assessment and
26 of the application to the secretary of the United
27 States department of health and human services for a
28 waiver of the uniform tax requirement pursuant to 42
29 U.S.C. § 1396b(w)(3)(E) and 42 C.F.R. § 433.68(e)(2).
30 If both approvals are received, section 249A.20B shall
31 take effect upon the date that both approvals have
32 been received by the department and the department
33 shall notify the Code editor of the date of receipt of
34 the approvals.
35 2. If both approvals described in subsection 1 are
36 not received by June 30, 2004, the section of this Act
37 enacting section 249A.20B shall not take effect."
38 3. Page 12, by striking lines 18 through 20.
39 4. Page 12, by inserting after line 27, the
40 following:
41 "4A. The portions of the section of this Act
42 enacting section 249A.20B relating to directing the
43 department of human services to submit a medical
44 assistance state plan amendment to the centers for
45 Medicare and Medicaid services of the United States
46 department of health and human services to effectuate
47 the nursing facility quality assurance assessment and
48 directing the department of human services to submit
49 an application to the secretary of the United States
50 department of health and human services for a waiver

Page 2

1 of the uniform tax requirement pursuant to 42 U.S.C. §
2 1396b(w)(3)(E) and 42 C.F.R. § 433.68(e)(2), being
3 deemed of immediate importance, take effect upon
4 enactment."
5 5. Page 12, line 30, by inserting after the word
6 "dates" the following: "and a contingent effective
7 date".
8 6. By renumbering as necessary.

Amendment H-1236 was adopted.

Osterhaus of Jackson asked and received unanimous consent that
amendment H-1240 to amendment H-1216 be deferred.

Osterhaus of Jackson offered the following amendment H-1252, to
amendment H-1216, filed by him from the floor and moved its
adoption:

H-1252

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 7, line 46, by striking the figure "4.26"
4 and inserting the following: "4.50".

Speaker Rants in the chair at 7:26 p.m.

A non-record roll call was requested.

The ayes were 45, nays 49.

Amendment H-1252 lost.

Osterhaus of Jackson offered the following amendment H-1253, to
amendment H-1216, filed by him from the floor and moved its
adoption:

H-1253

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 8, line 19, by striking the figure "12"
4 and inserting the following: "11".

Amendment H-1253 lost.

Osterhaus of Jackson offered the following amendment H-1254, to
amendment H-1216, filed by him from the floor and moved its
adoption:

H-1254

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 8, by striking lines 30 through 44.
4 2. By renumbering as necessary.

Amendment H-1254 lost.

Osterhaus of Jackson offered the following amendment H-1239, to
amendment H-1216, filed by him from the floor and moved its
adoption:

H-1239

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 9, by inserting after line 16, the
4 following:
5 "7A. The department of human services shall
6 continue the pharmaceutical case management program.
7 The university of Iowa college of public health, in
8 cooperation with the university of Iowa colleges of
9 pharmacy and medicine, shall provide oversight for the
10 pharmaceutical case management program and shall
11 submit annual reports regarding program savings and
12 quality improvement to the chairpersons of the joint
13 appropriations subcommittee on health and human
14 services of the general assembly."

Amendment H-1239 lost.

Osterhaus of Jackson offered the following amendment H-1249, to
amendment H-1216, filed by him from the floor and moved its
adoption:

H-1249

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 9, by inserting after line 16, the
4 following:

5 "7A. The department shall reimburse the dispensing
6 of prescription drugs for long-term care facility
7 residents at two cents per unit dose in addition to
8 the regular dispensing fee."
9 2. By renumbering as necessary.

Amendment H-1249 lost.

Eichhorn of Hamilton asked and received unanimous consent that
amendment H-1231 to amendment H-1216, be deferred.

Eichhorn of Hamilton offered the following amendment H-1229, to
amendment H-1216, filed by him from the floor and moved its
adoption:

H-1229

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 11, lines 34 and 35, by striking the
4 words "may procure a sole source contract with a
5 vendor" and inserting the following: "shall issue a
6 request for proposals or otherwise solicit bids from
7 potential vendors".

Amendment H-1229 was adopted.

Osterhaus of Jackson offered amendment H-1240, to amendment
H-1216, previously deferred, filed by him from the floor as follows:

H-1240

1 Amend the amendment, H-1216, to House File 619 as
2 follows:
3 1. Page 7, line 44, by inserting after the figure
4 "1." the following: "a."
5 2. Page 7, by inserting after line 47, the
6 following:
7 "b. The department of human services in
8 collaboration with the university of Iowa pharmacy
9 division of pharmaceutical socioeconomics shall
10 conduct a cost of dispensing study. Notwithstanding
11 paragraph "a" based on the results of the dispensing
12 study, the department shall establish a pharmacy
13 dispensing fee equal to one hundred five percent of
14 the average dispensing fee."

A non-record roll call was requested.

The ayes were 44, nays 51.

Amendment H-1240 lost.

Eichhorn of Hamilton offered the following amendment H-1231, to
amendment H-1216, previously deferred, filed by him from the floor
and moved its adoption:

H-1231

1 Amend the amendment, H-1216, to House File 619, as
2 follows:
3 1. Page 11, by striking line 12, and inserting
4 the following:
5 "Sec. ___. CHRONIC CARE MANAGEMENT."

Amendment H-1231 was adopted.

Carroll of Poweshiek moved the adoption of amendment H-1216,
as amended.

A non-record roll call was requested.

The ayes were 53, nays 43.

Amendment H-1216, as amended, was adopted.

RULE 32 INVOKED

Shoultz of Black Hawk rose on a point of order and invoked Rule
32.

The Speaker ruled the point well taken and House File 619 was
referred to the committee on ways and means.

RULE 57 SUSPENDED

Gipp of Winneshiek asked and received unanimous consent to
suspend Rule 57, relating to committee notice and agenda, for a
meeting of the committee on ways and means immediately.

The House stood at ease at 9:55 p.m., until the fall of the gavel.


The House resumed session at 10:07 p.m., Speaker Rants in the
chair.

COMMITTEE ON WAYS AND MEANS

House File 619, a bill for an act relating to health care including reimbursement of
health care facilities based on resident program eligibility.

Fiscal Note is not required.

Recommended Do Pass April 2, 2003.

The House resumed consideration of House File 619.

Carroll of Poweshiek moved that the bill be read a last time now
and placed upon its passage which motion prevailed and the bill was
read a last time.

On the question "Shall the bill pass?" (H.F. 619)

The ayes were, 54:
Alons Arnold Baudler Boal
Boddicker Boggess Carroll Chambers
De Boef Dennis Dix Dolecheck
Drake Eichhorn Elgin Freeman
Gipp Granzow Greiner Hahn
Hansen Hanson Heaton Hoffman
Horbach Huseman Hutter Jacobs
Jenkins Jones Klemme Kramer
Kurtenbach Lalk Lukan Maddox
Manternach Olson, S. Paulsen Raecker
Rasmussen Rayhons Roberts Sands
Schickel Tjepkes Tymeson Upmeyer
Van Engelenhoven Van Fossen, J.K. Van Fossen, J.R. Watts
Wilderdyke Mr. Speaker
Rants

 


The nays were, 46:
Bell Berry Bukta Cohoon
Connors Dandekar Davitt Fallon
Foege Ford Frevert Gaskill
Greimann Heddens Hogg Hunter
Huser Jochum Kuhn Lensing
Lykam Mascher McCarthy Mertz
Miller Murphy Myers Oldson
Olson, D. Osterhaus Petersen Quirk
Reasoner Shoultz Smith Stevens
Struyk Swaim Taylor, D. Taylor, T.
Thomas Wendt Whitaker Whitead
Winckler Wise

 


Absent or not voting, none.

The bill having received a constitutional majority was declared to
have passed the House and the title, as amended, was agreed to.

IMMEDIATE MESSAGE

Gipp of Winneshiek asked and received unanimous consent that
House File 619 be immediately messaged to the Senate.

SENATE MESSAGES CONSIDERED

Senate File 344, by committee on business and labor relations, a
bill for an act concerning regulatory and statutory requirements
impacting business relating to liability reform, unemployment
compensation benefits eligibility and employer contributions,
workers' compensation, occupational safety and health, financial
services, environmental regulatory requirements, public project
contractor requirements, and economic development.

Read first time and referred to committee on commerce,
regulation and labor

Senate File 372, by committee on commerce, a bill for an act
relating to the licensing of persons providing money transmission and
currency exchange services, providing penalties, and providing an
effective date.

Read first time and referred to committee on commerce,
regulation and labor.

Senate File 392, by committee on agriculture, a bill for an act
relating to the animal agriculture compliance Act, providing for
penalties, and providing an effective date.

Read first time and referred to committee on agriculture.

Senate File 412, by committee on human resources, a bill for an
act relating to the management of elder group homes.

Read first time and referred to committee on human resources.

MESSAGES FROM THE SENATE

The following messages were received from the Senate:

Mr. Speaker: I am directed to inform your honorable body that the Senate has on
April 2, 2003, passed the following bill in which the concurrence of the Senate was
asked:

House File 659, a bill for an act relating to ownership of alternate energy
production facilities by public utilities, making related changes, and providing an
effective date.

Also: That the Senate has on April 2, 2003, passed the following bill in which the
concurrence of the House is asked:

Senate File 354, a bill for an act implementing the federal Indian Child Welfare
Act.

MICHAEL E. MARSHALL, Secretary

PRESENTATION OF VISITORS

The Speaker announced that the following visitors were present in
the House chamber:

Eighty Senior students from Davis County Community High
School, Bloomfield, Iowa, accompanied by Mr. Pat Perry and Mr. Ed
Good. By Swaim of Davis.

SUBCOMMITTEE ASSIGNMENTS

House File 432

Appropriations: Eichhorn, Chair; Dolecheck and T. Taylor.

House File 651

Appropriations: Boggess, Chair; Dolecheck and Reasoner.

HOUSE STUDY BILL COMMITTEE ASSIGNMENT

H.S.B. 309 Appropriations

Relating to and making appropriations for health and human services
to the department of elder affairs, the Iowa department of public
health, the department of inspections and appeals, the department of

human services, and the commission of veteran affairs, and providing
effective dates.

H.S.B. 310 Government Oversight

Establishing a veterans trust fund under the control of the
commission of veterans affairs and making an appropriation.

COMMITTEE RECOMMENDATIONS

MR. SPEAKER: The Chief Clerk of the House respectfully reports
that the following committee recommendations have been received
and are on file in the office of the Chief Clerk.

MARGARET A. THOMSON
Chief Clerk of the House

COMMITTEE ON AGRICULTURE

Senate File 379, a bill for an act relating to certain agriculture liens.

Fiscal Note is not required.

Recommended Amend and Do Pass with amendment H-1246 April 2, 2003.

Senate File 394, a bill for an act relating to the regulation of the grain industry,
and making penalties applicable.
Fiscal Note is not required.

Recommended Do Pass April 2, 2003.

Senate File 395, a bill for an act relating to assistance services provided to the
department of agriculture and land stewardship, including for the filing of documents
and the payment of fees and civil penalties, and the authorization to assess additional
charges.

Fiscal Note is not required.

Recommended Do Pass April 2, 2003.

Senate File 396, a bill for an act providing for the animal unit capacity of pullets
for purposes of regulation under the animal agriculture compliance Act.

Fiscal Note is not required.

Recommended Amend and Do Pass with amendment H-1247 April 2, 2003.


COMMITTEE ON HUMAN RESOURCES

Senate File 351, a bill for an act relating to child care requirements involving
prohibitions against involvement with child care, record checks and evaluations
performed by the department of human services, eligibility for state assistance, and
child care fraud program sanctions, and making penalties applicable.

Fiscal Note is not required.

Recommended Amend and Do Pass with amendment H-1245 April 2, 2003.

COMMITTEE ON NATURAL RESOURCES

Senate File 297, a bill for an act relating to the regulation of snowmobiles and all-
terrain vehicles, establishing fees, providing penalties, and providing applicability
dates.

Fiscal Note is required.

Recommended Amend and Do Pass with amendment H-1244 April 2, 2003.

Pursuant to Rule 31.7, Senate File 297 was referred to the committee on
ways and means.

RESOLUTION FILED

HR 51, by Eichhorn, a resolution supporting the nomination of
federal court of appeals judicial nominee Miguel A. Estrada.

Laid over under Rule 25.

AMENDMENTS FILED

H-1222 H.F. 654 Jochum of Dubuque
H-1223 H.F. 595 Tjepkes of Webster
H-1224 H.F. 595 Tjepkes of Webster
H-1226 H.F. 654 Jochum of Dubuque
Shoultz of Black Hawk
H-1227 H.F. 663 Wendt of Woodbury
H-1228 H.F. 448 Kurtenbach of Story
H-1232 S.F. 390 Elgin of Linn
H-1233 S.F. 390 Elgin of Linn
H-1234 H.F. 502 Hoffman of Crawford
H-1235 S.F. 433 Wendt of Woodbury
Whitead of Woodbury
Struyk of Pottawattamie

H-1237 H.F. 662 Tymeson of Madison
Paulsen of Linn Dolecheck of Ringgold
Wilderdyke of Harrison Chambers of O'Brien
Raecker of Polk Hansen of Pottawattamie
Kramer of Polk Boddicker of Cedar
Rayhons of Hancock Manternach of Jones
Alons of Sioux Drake of Pottawattamie
J.R. Van Fossen of Scott Lukan of Dubuque
J. K. Van Fossen of Scott Kurtenbach of Story
H-1238 H.F. 654 Hogg of Linn
H-1241 H.F. 553 Maddox of Polk
H-1242 S.F. 435 Eichhorn of Hamilton
H-1243 S.F. 435 Eichhorn of Hamilton
H-1244 S.F. 297 Committee on Natural Resources
H-1245 S.F. 351 Committee on Human Resources
H-1246 S.F. 379 Committee on Agriculture
H-1247 S.F. 396 Committee on Agriculture
H-1248 H.F. 542 Baudler of Adair
J.R. Van Fossen of Scott
H-1255 H.F. 617 Greiner of Washington
H-1256 H.F. 595 Huser of Polk
H-1258 S.F. 297 Baudler of Adair
H-1259 H.F. 448 S. Olson of Clinton
H-1260 H.F. 595 Wise of Lee
H-1261 H.F. 662 Jenkins of Black Hawk
Dennis of Black Hawk Kurtenbach of Story
Winckler of Scott Davitt of Warren
Greimann of Story
H-1262 H.F. 595 Wise of Lee

On motion by Gipp of Winneshiek the House adjourned at 10:27
p.m., until 8:45 a.m., Thursday, April 3, 2003.

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